Factors associated with caregiving appraisal of informal caregivers: A systematic review

Abstract

Aims and objectives To identify factors associated with the caregiving appraisal of informal caregivers. Background Caregiving appraisal, the cognitive evaluation of the caregiving situation, is an essential factor in determining positive or negative caregiving outcomes. Identifying factors associated with appraisal is fundamental for designing effective health promotion strategies. Design A systematic review. Methods PubMed, EMBASE, CINAHL, PsycINFO, Social Sciences Citation Index, Scopus, CNKI and Wanfang Database were searched for papers published from 1984 to December 2018. Keywords related to informal caregivers' caregiving appraisal were used. Cross‐sectional and cohort studies were included. The Quality Assessment and Validity Tool for Correlational Studies, and the CASP Cohort Study Checklist were used for quality assessment. Descriptive and narrative synthesis were used to analyse data. Social ecological model was used for classifying the associated factors into different levels. The PRISMA checklist was followed. Results Forty studies were included. The quality of the studies was moderate to high. Data were organised into three levels (individual, interpersonal and community level) and categorised into modifiable factors (e.g. patient behavioural problems, caregiver self‐efficacy and social support) and nonmodifiable factors (e.g. caregiving duration, gender and education). The majority of studies have investigated the factors at the individual level. Conclusion There are inconsistencies in the understanding of caregiving appraisal, and consensus is needed for conceptual clarity. Caregiving appraisal is associated with three levels of factors. These modifiable factors provide evidence for designing evidence‐based interventions, and the nonmodifiable factors help identify confounding factors in assessment and appraisal. Relevance to clinical practice Nurses are the best‐placed healthcare professionals to support informal caregivers. The three levels of associated factors and the interactive approaches provide direction for informing clinical nursing practice. They also provide evidence for healthcare researchers and policymakers to develop interventions and theoretical perspectives and to better allocate healthcare resources.

A Biopsychosocial-Ecological Framework for Family-Framed Dementia Care

“…O'Shea et al (32) used a social ecological framework to understand how various stakeholders perceived access to respite services and to explore the boundaries of public responsibility in relation to client care preferences. Wang et al (33) used a social ecological approach to understand how individual, interpersonal, and community level factors influenced informal caregiver appraisals of their caregiving experiences.…”

The Development of an Evidence-Based Telephone-Coached Bibliotherapy Protocol for Improving Dementia Caregiving Appraisal

“…Figure 1 defines the theory and modeling phases of the MRC Framework and maps them onto the methods used to develop the bibliotherapy protocol. Triangulation of evidence (i.e., a series of reviews [ 6 , 15 , 18 ] and focus group interviews) was used to develop and validate the intervention.…”

“…We did a systematic review of bibliotherapy and found that bibliotherapy could improve the depression, self-efficacy and state anxiety among informal caregivers of people with neurocognitive disorder (i.e., including dementia) [ 15 ]. It also has the potential to improve caregiving appraisal, because depression and self-efficacy are significantly associated with caregiving appraisal [ 16 , 17 , 18 ]. However, very limited bibliotherapy studies have been conducted among dementia caregivers, and no study has been conducted among Chinese caregivers; therefore, an evidence-based bibliotherapy protocol is needed [ 15 ].…”

Bibliotherapy for improving caregiving appraisal of informal caregivers of people with dementia: A pilot randomized controlled trial

“…However, no study measured the efficacy on improving caregiving appraisal. As caregiving appraisal was associated with depression and self‐efficacy (S. Wang et al, 2020), it was postulated that bibliotherapy might also improve caregiving appraisal. Caregiving appraisal was mentioned in both Lazarus and Folkman (1986) and Lawton et al (1991) theoretical models.…”

“…In this study, a bibliotherapy protocol was developed based on Lazarus and Folkman (1986) and Lawton et al (1991) theoretical models; the systematic reviews on caregiving appraisal (S. Wang et al, 2020) and bibliotherapy (S. Wang et al, 2020); and the mechanism of bibliotherapy (Figure 1). This study addresses the research gap by exploring the feasibility and acceptability of bibliotherapy with a pilot randomized controlled trial.…”